Physiological stress management

• What is Drug therapy for stress?


  The use of medication/drugs to manage stress or feelings of anxiety.
• What is the medication used to treat stress?


  Benzodiazepines (BZ)
• How do Benzodiazepines work to treat stress?

  • increase the action of the neurotransmitter GABA.
  • 'dampens down' activity of other neurotransmitters in the brain which relieves symptoms of stress & anxiety.
  • Patient feels calmer and better able to manage their day.
• What are the types of Benzodiazepines?


  • Diazepam
  • Chlordiazepoxide
• What can most drugs cause?


  Due to their addictive elements it can result in physical dependency (via changing brain structure/function)
• What can happen if a person stops taking a drug?

  Withdrawal symptoms such as sweating, shaking, tremors and faster heart rate are common.
• Why must a patients family or carers know about taking the drug?


  For ethical reasons family and carers need to be aware of potential side effects of taking BZ drugs.
• What are beta-blockers?

  A medication/ drug to stabilise heart rate and manage high blood pressure
• How do beta-blockers work?

  • Focuses on the heart & circulatory systems by stabilising heart rate and blood pressure.
  • Can be prescribed for stress/addiction related stress.
  • Blocks the effects of norepinephrine (fight or flight hormone)
  • Controls physical symptoms of shaking, shallow breathing, increased heart rate.
  • Does not have major side affects but doesn't target cause of stress only the symptoms.
  • Therefore, incomplete stress management technique.
• What are the types of beta-blockers?

  • Propranolol
  • Atenolol
• What is the biofeedback treatment?

  Patients are wired up to equipment that tracks and measures physiological responses (eg pulse or heart rate when stress is triggered via images and sounds).
• How does the biofeedback treatment work?

  • Pulse/heart rate increases because of stress triggers (eg caused by images or sounds)patient practices relaxation techniques.
  • If stress decreases (i.e. lower heart/pulse rate) then patient can see which relaxation technique works.
  • Positive feedback from the biofeedback (i.e. visual feedback of reduced pulse/heart rate) reinforces the patient's belief in the relaxation technique and they can apply it to deal with stressors in their life.
• Does bio feedback work? (YES)


  • Attanasio et al suggests biofeedback is an effective technique as it works well for tension headaches, particularly in children.
  • fewer side effects than drugs and it has been proven to reduce blood pressure, therefore it’s also more ethically acceptable to patients, their family and carers.
• Does bio feedback work? (maybe not...)


  • Patients need to be motivated and committed to a biofeedback programme.
  • can take several weeks and involves effort as several relaxation techniques need to be learnt.
  • time consuming, so may not be practical for patients to complete the training (i.e. work/family commitments)
  • training is laboratory based, techniques learned may not be as effective when applied to real life situations.